First Responder, Edmonton/Sherwood Park Counselling for Trauma and PTSD

PTSD, trauma reactions, workplace stress and other mental health issues are now recognized as a common risk for police, paramedics, EMTS, firefighters and 911 dispatch workers. Edmonton Emergency Medical Service (EMS) providers recognize more and more the benefit of having psychologists and therapists who are trained in providing therapy and counselling for First Responders. In turn, many First Responder agencies have increased their funding support to help their staff overcome the cumulative harm of chronic trauma exposure.

Who are First Responders?

First Responders are the people who come to help when life is not going well. First Responders are Police, Firefighters, Emergency Medical Technicians (EMT's), Paramedics, trained rescuers (e.g. SARS) and front line Child Welfare Workers and Investigators. First Responders include 9-1-1 Dispatch Operators, Coroners, Crime Scene Technicians, and Morticians. Nurses and physicians who work 'in the field' may also be First Responders. First Responders are the people who run towards danger, who are there in the aftermath of tragedy, and who subsume themselves in the details of what went wrong, in order to find ways to better protect, rescue and heal in the future.

First Responders are typically found at the scene of accidents, natural disasters, human conflict, and at events were there is the potential for illness or injury. As a result, a First Responders contact with the public often involves emotionally distressing situations. On a daily basis they are expected to deal with sights and experiences most people will never know. A First Responder's job is to protect and preserve life, property, evidence, and the environment - and in some situations these mandates are in conflict, resulting in the potential for further distress.

First Responders are also everyday people. They have the same challenges and struggles with spouses and partners, friends, children, personal history, workplace demands, and life stressors as any other person. Due to their employment, these common difficulties are often magnified by shift work, disrupted sleep patterns, and a sometimes unappreciative public.

Superhero on the outside, Trauma on the inside

First Responders are viewed by the public as highly emotionally resilient individuals. They are expected to 'be tough'. They are expected to 'remain calm under pressure at all times'. They are expected to be the consummate professionals, no matter what is going on around them, what people say to them, or how they may personally feel threatened or attacked. Unlike for the average citizen, if a First Responder slips, or has a bad day, someone else may be permanently injured, suffer illness needlessly, or die. Even when a First Responder does everything correctly their actions may be reviewed and judged by others who have no real understanding of the experience or the job.

To do all this, many First Responders learn to box up their emotions and thoughts. They attempt to segregate their work life from their home life. They find the only people who can understand how they are feeling are their work colleagues. Yet, while colleagues may be a great support, they may also send the message that emotional distress is not something to be shared, even acknowledged. This may leave a First Responder isolated and alone to deal with their distress.

Evidence of Mental Distress in First Responders

We can all do with a little TLC. Yet too often police, firefighters, paramedics / EMTs, child welfare workers and other First Responders are left to their own resources to try to understand and deal with the impact their distressed emotions. Distressed emotions triggered by daily exposure to accidents and injury, illness and neglect, abuse and trauma.

It is very likely that the effort to deny or minimize distress eventually weakens a persons general psychological health. This weakening may make a person susceptible to Posttraumatic Stress Disorder (PTSD) and other mental illnesses.

Research on First Responders' mental health has only recently become a priority. What information is available is limited in amount and quality, with only a few studies that are repeatedly referenced. The findings so far shows that First Responders are at high risk for depression, anxiety, family dysfunction, negative work-site interactions / bullying, substance use /abuse, PTSD, and toxic stress. Over time, ongoing toxic stress leads to increased rates of heart disease, cancer, arthritis, diabetes, and other medical illnesses. Most concerning, the suicide rate for EMT/paramedics and police is very much higher than the general population.

The Suffering Spreads

Shift-work, chronic sleep deprivation, self-medication with drugs and alcohol along with sometimes toxic work environments, may further confound natural healing processes. Over time, these behaviors may result in First Responders withdrawing from family members. As a result, families of police, firefighters, EMT/paramedics and other First Responders experience a high rates of marital problems and family breakdown. It is important that the families and spouses of First Responders also have easy access to high quality mental health services.

PTSD In First Responders Formally Acknowledged

In 2013 a section regarding Post Traumatic Stress Disorder was added to the Fifth edition of the Diagnostic and Statistical Manual (DSM-5), otherwise known as the diagnostic 'bible' of mental illness. This new section was specifically designed to recognize the negative psychological impact First Responders' work has on their mental well-being. Now there is recognition that repeated exposure to traumatic events, or details about those events can cause the same amount of mental harm as directly experiencing the event.

First Responders deserve Expert Help

Treating First Responders is not like treating members of the general population. Psychologists and therapists who work with First Responders need to know the culture, humour, and mindset of this community to provide therapy that is meaningful. The last thing a First Responder needs is a therapist who becomes distressed at a police officers description of a murder scene, or a paramedic's dark joke about a patient. What may be normal or unremarkable for a First Responder may vary significantly from the civilian population, and a good First Responder therapist will understand.

Because many First Responders often will not seek psychological help until they are struggling in several areas of their life, it is crucial that psychologists, therapists, and counsellors working with the First Responder community have extensive experience and training in a wide rage of expertise. Treating clinicians must to be able to understand how shift-work and the associated sleep disruptions impact stress tolerance and eating habits. The therapist must be able to grasp how home-life struggles may influence on the job performance. They must be more than competent at treating co-morbid addictions, trauma, and mental health issues. And, of course, all treatment must be tailored to address any historical challenges (e.g. negative childhood events, prior poor relationships, etc.) that have reemerged due to the First Responder's current distress.

First Responders are Not Alone

The psychologists and therapists at Firefly Counselling have considerable training and experience in trauma counselling, along with helping First Responders deal with the common co-morbid issues of insomnia, depression, anxiety, family difficulties, and substance abuse challenges. Because we have so much experience we are not given to overreacting to our client's life stories. We have worked hard to make our office a safe haven.

Firefly Counselling is a place of understanding, support, good laughs, and most of all, a place of healing. All the clinicians who work Firefly were selected because of their special interest in working with people struggling with trauma, and with First Responders in particular. Karin is an approved Alberta Paramedic Association (APA) psychologist for paramedics / EMT. The bulk of Karin's practice is with members of the Edmonton Police Service (EPS), RCMP, Edmonton Fire Department (EFD), EMT / Paramedics, military personnel and dispatch workers for various First Responder groups.